Vishnupriya Chest pain is a leading cause of death and is commonly referred to as “chest pain.” It typically originates from the heart and is felt in the chest. This pain can indicate a heart attack, which is often referred to as angina.
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Many other potential causes of chest pain may not be related to the heart. It’s essential to differentiate between heart-related chest pain and other types. Pain specifically arising from heart issues is known as “heartache.”
Heart attacks can be categorized into two types:
1. Stable angina
2. Unstable angina (often described as unrelenting heartburn)
Constant Heartburn
Heart disease is more prevalent among middle-aged men, while it is less common in women of the same age. On average, women experience heart pain about 10 years later than men due to the protective effects of estrogen. However, after age 65, the risk for both men and women becomes similar.
Individuals who are overweight, obese, diabetic, smokers, or have high blood pressure are at a greater risk of developing heart diseases.
The Main Cause of Heartburn
Coronary artery disease occurs when plaque builds up in the arteries that supply blood to the heart. While aging is a natural process, the rate of progression can vary depending on an individual’s diet and lifestyle.
As heart rate slows, blood flow to the heart muscle decreases. Although blood supply increases during rest, the heart demands more blood during physical activity. A narrowed coronary artery cannot meet this demand, resulting in inadequate oxygen supply to the heart muscle, causing it to ache.
Factors Provoking Heartburn
Several conditions can provoke heart pain, including:
1. Excessive physical exertion, severe dizziness, lack of sleep, or overeating
2. Sudden exposure to extreme cold
3. Ascending to high altitudes (e.g., climbing stairs or mountains)
4. Intense emotions such as anger, anxiety, or fear
5. Long-term stress or distress
6. Distressing dreams
In such situations, if a person experiences heartburn, it may likely be angina. However, heart-related pain can also occur spontaneously without any apparent triggers.
Beyond heartburn, many other causes can lead to chest pain. Therefore, it is crucial for anyone experiencing chest pain to consult a doctor to identify the underlying cause and receive appropriate treatment.
Other Causes of Chest Pain
1. Myocardial infarction (heart attack): Chest pain from a heart attack does not diminish with rest or by taking glyceryl trinitrate under the tongue.
2. Dissecting aortic aneurysm: This type of chest pain can start as sharp pain in the back, often associated with a low heart rate.
3. Pericarditis: This pain begins beneath the breastbone and can radiate to the shoulders. It often worsens with coughing or sneezing.
4. Pulmonary diseases: Conditions such as pneumonia or pneumothorax can cause chest pain that increases with breathing.
5. Musculoskeletal disorders: These can lead to pain in various chest areas, usually aggravated by touch, and may not improve with rest. However, appropriate treatment can relieve the pain.
6. Esophageal conditions: Swelling or ulcers in the esophagus or leading to the stomach can cause chest pain, especially when related to food intake. Pain may be alleviated with antacid or acid-reducing medications.
It can be challenging for a patient to identify the specific causes of their heart pain. Therefore, it is essential to undergo a medical examination.
The Tests
When a patient presents with heart pain, the medical team will first conduct a thorough physical examination. This includes measuring blood pressure, heart rate, and pulse. The presence of high blood pressure will be noted, along with any treatments the patient is currently undergoing. Blood and urine tests will be performed to check for diabetes, and if the patient is diabetic, the effectiveness of their current treatment will also be assessed. Additionally, blood tests will evaluate for conditions such as anemia, hyperlipidemia, and peripheral vascular disease.
**Chest X-ray:** This imaging test can reveal any diseases in the chest area and any changes in the ribs. It can also help in diagnosing cardiovascular disease.
**Electrocardiogram (ECG):** This simple test measures the heart’s electrical activity. Changes in the waveform—such as elevations, depressions, or inverted waves—can indicate potential issues.
Some patients may not show early signs of heart disease on the initial ECG and may require further testing.
**Exercise ECG:** In this test, the patient exercises while their heart’s response is monitored. Those with early-stage heart issues may experience chest pain, shortness of breath, or changes in blood pressure during exercise. An ECG will be taken post-exercise to assess for wave changes.
For most individuals, heart pain can often be indicated by distinct waveform changes. However, many cannot predict heart disease based solely on these changes, as similar ST wave alterations can occur for various reasons.
For instance, patients with pre-existing heart conditions, those taking digoxin, individuals with left ventricular hypertrophy, and those with left atrial fibrillation may exhibit similar ST fluctuations. Therefore, it’s crucial to consider these factors before predicting heart pain.
Isotope Scanning:
This test involves injecting a radioactive substance called thallium, similar to potassium, into a vein. Because of its nature, it is readily absorbed by the heart. A heart scan is then conducted, taking images before and after exercise. For those who cannot exercise, a drug called dobutamine may be used instead of thallium. The degree of thallium or dobutamine absorption in the heart tissue helps identify the nature of the heart disease. This test is performed when previous coronary artery tests have not been able to pinpoint the cause of heart pain. It can clearly identify the nature and severity of the disease, typically before procedures such as coronary artery bypass grafting or coronary angioplasty, allowing for a better understanding of any blockages in the coronary arteries.
Diagnosis:
It takes a lot of time to do all of the above tests to completely confirm a heart attack. Therefore, the patient with chest pain should start treatment as soon as possible, confirming the diagnosis by examining the heart’s electrical map alone. After reducing the patient’s chest pain and avoiding exacerbation of the disease, the patient can be subjected to other tests.
It is advisable to admit patients with chest pain to a hospital with modern cardiac care facilities. If this is not possible at first, you can seek first aid at the nearest hospital and then proceed to a hospital with modern cardiac care facilities.
First aid for heart attack
In case of chest pain, one of the medicines’ Laye ‘nitrate can be given on the way to the hospital. This is the main thing. Glyceryl trinitrate includes isosorbite dinitrate. If one of these tablets is placed under the tongue, it will immediately dissolve in saliva, dissolve in the blood, reach the coronary artery and cause it to dilate. The affected heart tissue receives blood. This will immediately reduce the pain.
At the same time, these drugs can also cause headaches as they dilate other blood vessels in the body. Sometimes the headache is more severe than the chest pain.
Medical treatment of heartburn
Anti-inflammatory drugs
As already mentioned, if you put a tablet of glycerin trinitrate under your tongue, the heartburn will immediately subside. However, it only works for about half an hour. In addition, isosorbite dinitrate is an isosorbite mononitrate that can be consumed orally. Isosorbide works for 10 hours. It is also available as a laxative. Spray the medicine under the tongue in case of chest pain. Glyceryl trinitrate glue and bandages are useful for those who constantly need this medication. Ib. If the paste is applied on the skin or this bandage is applied on the skin then the medicine gets absorbed in the blood and reaches the heart. Also, the drug is given intravenously to people with unstable heart and sudden heart failure.
Medications given in case of chest pain and other ailments
Beta-blockers for high blood pressure
One of these drugs is given to people with depression. The most important of these are the (Metoprolol) and etc. They inhibit chemical transduction in beta cells in the nervous system. As a result, blood pressure decreases, heart function improves, heart rate returns to normal, and heart pain decreases.
These drugs should be used with caution in people with low heart rate, heart failure, and heart failure.
Calcium antagonists
Amlodipine, Nifedipine, Nicotipine, Verapamil, Diltiazem etcetera belong to this class of drugs. This is another type of medication used for patients with high blood pressure and heartburn. These drugs are given to patients who are unable to use beta-blockers. Sometimes a combination of both drugs is used. A doctor will prescribe one of the statin types of medication for people with high blood cholesterol.
If the patient has co-morbidities such as diabetes, anaemia, and circulatory disorders, they will also be treated appropriately.
In the case of heart patients these medicines should be taken throughout the life. The dosage of the drug can vary depending on the severity of the disease. Therefore, it is necessary to consult a doctor from time to time.
Surgery for heart attack
1. Coronary artery bypass grafting is used to prevent recurrence of a heart attack. In this, the blocked coronary artery is left intact, the Saphenous Vein or Internal Mammary Artery is removed from the leg, one end of it is implanted in the aorta and the other end is implanted beyond the blocked coronary artery, creating an ‘alternative’ way for blood to flow to the heart. The treatment is carried out when all three heart arteries are affected.
It is considered to be a wonderful method of rehabilitation for heart patients. It has been confirmed that 85 percent of those who received this treatment did not have cardiovascular disease for 10 years, and the average life expectancy after this treatment was greatly increased.
2. Coronary angioplasty is used to treat people who are unable to have a heart transplant due to old age and other health problems. This treatment is done when one or both of the coronary arteries are affected and those who have already had coronary artery replacement therapy have a recurrence of coronary artery blockage. In this, a very small balloon is injected into the heart through a flexible tube, where it is inflated to widen the narrowed vessel. It is used as a temporary treatment. People who have had this treatment have a higher chance of having a heart attack again.
. This is a modern treatment that removes the blockage of the heart artery by injecting a laser beam into the heart, instead of surgical treatment for heart pain. This is currently being implemented.
Preventive Tips:
: The article titled ‘Ways to Prevent Heartburn “provides detailed tips to help prevent heartburn. However, only the most important ones are listed here:
1. Don’t smoke.
2. Body height and age should be considered.
3. Exercise regularly every day.
4. Fatty foods should be avoided.
5. Those who have already had heartburn should keep the nitrate tablet under the tongue in case of mild chest pain again.
Unrelenting heartburn
A heart attack looks like a heart attack. It is a cat on the wall between the two, without constant heartache or heart attack. At the same time, it is ready to become a heart attack at any time. Doctors call it “unstable angina” because the condition is not permanent. Heart disease can also be described as: Persistent heart pain that occurs when there is a blockage in the coronary artery. A heart attack occurs when a blockage in a coronary artery either completely closes the coronary artery or completely closes it.
An irregular heartbeat is more dangerous than a normal heartbeat. About 15 percent of those infected die.
The pain is most severe in the left side of the chest. Although the pain doesn’t stop, it still persists. It is suspected to be a heart attack. Although there are no visible signs of a heart attack on the heartbeat diagram, the pain can last for a long time and can turn into a heart attack at any time. Therefore, the patient should be immediately taken to a medical establishment. All possible treatments should be given for constant heartburn. The course of the disease should be monitored. It should be treated when it becomes a heart attack.